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Psychosis From Anticholinergic Medications Administered at a Smoking Cessation Clinic

From the Wake Area Health Education Center, Raleigh, North Carolina (JAM, TST); University of North Carolina, Eshelman School of Pharmacy, Chapel Hill, North Carolina, (TST); and Wake Forest University Health Sciences, Section on Cardiology, Winston Salem, North Carolina, (SAS). JAM was a student at Wake Area Health Education Center when this article was written.

Correspondence: Toyin S. Tofade, University of North Carolina, Eshelman School of Pharmacy, Chapel Hill, NC; e-mail: ttofade{at}wakemed.org.

Anticholinergic medications are used for a variety of reasons, from their effects on the central nervous system to their effects on the gastrointestinal tract. They are used in the treatment of Parkinson’s disease, vertigo, gastroesophageal reflux disease, and peptic ulcer disease. They have also been used in the treatment of motion sickness. These medications must be used with caution due to their effects on other systems, including the central nervous system. Common central nervous system side effects due to anticholinergic medications include sedation, delirium, amnesia, and in the case of the patient presented in this report, psychosis. A 61-year-old man presented to the emergency department with visual and auditory hallucinations secondary to anticholinergic medications (scopolamine and atropine) he received in a smoking cessation clinic. Previous cases of anticholinergic medication–induced psychosis are also summarized.

Key Words: smoking cessation • anticholinergics • toxicity • psychosis • hallucinations • delirium • scopolamine

This version was published on October 1, 2009

Journal of Pharmacy Practice, Vol. 22, No. 5, 489-493 (2009)
DOI: 10.1177/0897190008330201


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